Premenstrual Moods

Colette Dowling, LCSW

New York Psychotherapist

Colette Dowling, LCSW

Colette Dowling, LCSW, author of the following article on premenstrual
moods, is a psychotherapist in Manhattan. She has written 8 books on
women's psychological issues, including "You Mean I Don't Have to Feel
This Way?": New Help for Depression, Anxiety and Addiction, and The
Cinderella Complex.

Premenstrual moods, including premenstrual depression, anxiety,
and irritability result from the impact of reproductive hormones on the
brain.

When you experience Premenstrual Mood Change (popularly known as
PMS, medically known as PMDD), your brain is telling you that it's
unable to maintain its usual chemical balance during the last week of
the cycle. How magical it seems when your brain recovers its intrinsic
regulating abilities, within a day or two after menstruation begins,
and suddenly the premenstrual moods are gone and you feel normal again!

Every woman who suffers from PMS knows what it's like to feel ashamed,
helpless and out of control. Her mood swings may feel profoundly
disorienting. Who she IS, during that week or 10 days before her period,
doesn't quite feel like the "real" her. Irritability plagues her. She
may fight with her husband, say terrible things to her children. She has
no patience with the bank teller and chews out the school crossing
guard. Moreove, she knows her irritabilty is irrational and hates
herself for it.

Today it's known that up to 60 percent of women suffer from
premenstrual moods. The symptoms of PMS--which may include depressed
mood, anxiety and irritability, in addition to physical symptoms such as
bloating and breast tenderness--are actually caused by neurotransmitter
changes in the brain.

These changes are triggered by the drop in estrogen that occurs
after a woman ovulates. Lowered estrogen causes mood-altering serotonin
levels to drop, too, and that's where the difficulty begins.

"Hormones are, by definition, substances that act as messengers
at target organs", doctors Severino and Moline wrote in their 1989 book,
Premenstrual Syndrome. In this syndrome the "target organs" are the
brain, breasts, and uterus, with secondary effects occurring at the
thyroid and the adrenal cortex. The regulation of menstrual hormones
involves complex interactions among brain neurotransmitters, pituitary
hormones, and ovarian hormones. Thus, it isn't simply the woman's
ovaries that cause her premenstrual difficulties. Her serotonin,
dopamine, and norepineprhine are part of the action as well. Somehow,
the ovarian hormones interact with the brain's neurotransmitters and the
end result is a definite shift in mood.

WE mayh wonder why Betty binges through her periods and Helen
finds that she becomes moody and irritated. Why is one woman beleaguered
by the hanges only one week out of every month and another three weeks?
Why do some experience a mild feeling of being in the dumps and others
have severe, life-disrupting mood drops? And why do some swing through
the whole cycle, as a minority do, as free and easy as a woman in a
Maxithin commercial?

One theory is that women who have low serotonin levels to begin
with are likely to have their serotonin drop below a tolearble level
when their estrogen declines
Though physical in origin, the mood shifts and sometimes extreme
behaviors many women experience, premenstrually, may benefit from a
psychiatrist's help. If youj're considering antidepressant medication
for premenstrjual mood changes (and some women feel like this medication
returns their lives to normal),a psychiatrist is more experienced at
prescribing medication and proper dosing for the treatment of PMS than
an OB/GYN or family practioner.

Women struggling with the effects of premenstrual moods can also
be helped by psychotherapy.Self image tends to be altered by the
once-a-month downturn in self esteem and the consequent relationship
difficulties. This can be effectively addressed by someone who
understands both the physical and emotional components of PMS, or PMDD.

* * *

A discussion of premenstrual moods can be found in Colette Dowling's
book, "You Mean I Don't have to Feel This Way?": New Help for
Depression, Anxiety and Addiction.

Colette Dowling, LCSW, received her MSW degree at The Smith College
School for Social Work. Subsequently, she completed psychoanalytic
training at The Institute for Contemporary Psychotherapy, in New York.
Ms. Dowling is a licensed clinical social worker with a private
therapy practice in Manhattan. She specializes in the treatment of women
and couples. For further information, or to arrange a consultation,
call Colette at 718-594-0201, or write dowlingcolette@earthlink.net

To hear Colette speaking about what it's like starting therapy with someone new, click the audio button.